As one of the main vendors in the ambulatory EHR space, Allscripts has been getting a lot of calls since HITECH moved the market. But in a change from the past, those calls are not only coming from interested physicians, but from hospital CIOs who want to underwrite licenses for both owned and independent practices. As the vendor’s deal with New York's North Shore Long Island Jewish attests, the sale of ambulatory EHRs is, more and more, moving through the hospital CIO's office. To learn more about how HITECH is effecting the sale of outpatient EHRs, HCI Editor-in-Chief Anthony Guerra recently talked with Allscripts CEO Glen Tullman about where he sees the market going.
GUERRA: What would your advice be to hospitals CIOs that want to engage IPAs?
TULLMAN: Well, I think everybody is talking today. I think you have to be going out there engaging in the market, you have to be talking with a variety of players. This is changing, and it is happening in real time. The time is now, and this is happening now. So from that perspective, I would just encourage people not to sit back.
GUERRA: Epic wins a lot of deals because they can offer both acute and ambulatory products. How do you feel going forward with just having the ambulatory piece?
TULLMAN: Epic touts one system and, in fact, they’re very much fighting integration. But we all know that the ability for a hospital to own every practice and every system, that’s just not the American way. I mean, go out in the market, is everybody going to be forced onto the Epic system? I don’t think so. So we think a better strategy is to integrate with what people have. They aren’t going to go and rip out all the Cerner systems to put Epic in. That’s not realistic. So we work with, and we are willing to work with, anyone and everyone to integrate our systems. Why? Because it’s better for the patient and that’s what healthcare ought to be about. So the Epic philosophy of, “We are going to force people to use Epic and just use one system,” that’s their philosophy, but I don’t think it fits with where the country is. So I see us as a country saying, “We have a variety of systems out there, and we’re going to have those systems in place for years and years, and we have to fix healthcare now.”
GUERRA: What do you mean when you say Epic is very much fighting integration?
TULLMAN: Their philosophy is not to open up their system because they want to force people to buy only Epic, and they make it very hard to change information, to share information and the like. Whereas all of the other major systems are working cooperatively, they’re the exception.
GUERRA: Have you ever dealt with a hospital that had Epic as an inpatient system and wanted Allscripts as their ambulatory solution?
TULLMAN: I don’t really think that’s happened, but I couldn’t tell you for sure. I would just say, generally, they are known in the market for being very, very difficult to work with.
GUERRA: What are your thoughts on where certification is going?
TULLMAN (who is a member of the CCHIT Board of Trustees): Well, first of all I think that right now the general thought is that CCHIT is just in the process of publishing some guidelines now, and that they will be the certifying body. The government has left open the ability to have others. I don’t think that’s a good thing. I think having multiple standards is kind of like VCRs and Betamax. That caused a lot of havoc as opposed to having one standard. Let’s have people compete on the quality of the systems, as opposed to which standard they’re using. So we’re big supporters of CCHIT, we’re big supporters of one standard for the market, and we’re supporters of increasing those standards to make it tougher on the vendors.
We ought to force interoperability, within 18 months all systems should be able to exchange information in a CCR or CCD format, we ought to have minimum requirements that are very tough in order to get the taxpayers’ money. What the taxpayers are investing in is helping us to get better information, and we have to get that information, we have to be able to communicate that information, and share that information. So that’s our position – use CCHIT, make it tougher on the vendors by increasing the standards, force interoperability within 18 months or 24 months at the latest, and help us build a connected system of health using information technology.
GUERRA: My interpretation is not that they’re proposing different standards for different certifying entities, but one set of criteria from HHS or CMS.
TULLMAN: I think there’s a lot of discussion around it. At least the initial conception was there could be two or three bodies that did certification. What that would set up is vendors might choose to go to one certification body or another, which again, we think doesn’t make a whole lot of sense. So we’re pleased that, at least initially, CCHIT looks to be the sole body to do the certifications. We’re hopeful that happens.
GUERRA: What products do you plan on getting certified by whatever entity winds up doing it? Do you plan on supporting all of your software, including the Misys products?